The Experts below are selected from a list of 5292 Experts worldwide ranked by ideXlab platform
Mike English - One of the best experts on this subject based on the ideXlab platform.
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collective strategies to cope with work related stress among Nurses in resource constrained settings an ethnography of Neonatal nursing in kenya
Social Science & Medicine, 2020Co-Authors: Jacob Mcknight, Mike English, Jacinta Nzinga, Joyline JepkosgeiAbstract:Abstract Kenyan Neonatal Nurses are asked to do the impossible: to bridge the gap between international standards of nursing and the circumstances they face each day. They work long hours with little supervision in ill-designed wards, staffed by far too few Nurses given the pressing need. Despite these conditions, a single Neonatal Nurse can be tasked with looking after forty sick babies for whom very close care is a necessity. Our 18-month ethnography explores this uniquely stressful environment in order to understand how Nurses operate under such pressures and what techniques they use to organise work and cope. Beginning in January 2015, we conducted 250 h of non-participant observation and 32 semi-structured interviews in three newborn units in Nairobi to describe how Nurses categorise babies, balance work across shifts, use routinised care, and demonstrate pragmatism and flexibility in their dealings with each other in order to reduce stress. In so doing, we present an empirically based model of the ways in which Nurses cope in a lower-middle income setting and develop early work in nursing studies that highlighted collective strategies for reducing anxiety. This allows us to address the gap left by prevalent theories of nursing stress that have focused on the personal characteristics of individual Nurses. Finally, we extend outwards from our ethnographic findings to consider how a deeper understanding of these collective strategies to reduce stress might inform policy, and why, even when the forces that create stress are alleviated, the underlying model of nursing work may prevail.
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Exploring the space for task shifting to support nursing on Neonatal wards in Kenyan public hospitals.
Human resources for health, 2019Co-Authors: Jacinta Nzinga, Jacob Mcknight, Joyline Jepkosgei, Mike EnglishAbstract:Nursing practice is a key driver of quality care and can influence newborn health outcomes where Nurses are the primary care givers to this highly dependent group. However, in sub-Saharan Africa, nursing work environments are characterized by heavy workloads, insufficient staffing and regular medical emergencies, which compromise the ability of Nurses to provide quality care. Task shifting has been promoted as one strategy for making efficient use of human resources and addressing these issues. We aimed to understand the nature and practice of Neonatal nursing in public hospitals in Nairobi so as to determine what prospect there might be for relieving pressure by shifting Nurses’ work to others. This paper is based on an 18-month qualitative study of three newborn units of three public hospitals—all located in Nairobi county—using an ethnographic approach. We draw upon a mix of 32 interviews, over 250 h’ observations, field notes and informal conversations. Data were collected from senior nursing experts in newborn nursing, Neonatal Nurse in-charges, Neonatal Nurses, nursing students and support staff. To cope with difficult work conditions characterized by resource challenges and competing priorities, Nurses have developed a ritualized schedule and a form of ‘subconscious triage’. Informal, organic task shifting was already taking place whereby particular nursing tasks were delegated to students, mothers and support staff, often without any structured supervision. Despite this practice, Nurses were agnostic about formal institutionalization of task shifting due to concerns around professional boundaries and the practicality of integrating a new cadre into an already stressed health system. Our findings revealed a routine template of Neonatal nursing work which Nurses used to control unpredictability. We found that this model of nursing encouraged delegation of less technical tasks to subordinates, parents and other staff through the process of ‘subconscious triage’. The rich insights we gained from this organic form of task shifting can inform more formal task-shifting projects as they seek to identify tasks most easily delegated, and how best to support and work with busy Nurses.
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Exploring the space for task shifting to support nursing on Neonatal wards in Kenyan public hospitals
BMC, 2019Co-Authors: Jacinta Nzinga, Jacob Mcknight, Joyline Jepkosgei, Mike EnglishAbstract:Abstract Background Nursing practice is a key driver of quality care and can influence newborn health outcomes where Nurses are the primary care givers to this highly dependent group. However, in sub-Saharan Africa, nursing work environments are characterized by heavy workloads, insufficient staffing and regular medical emergencies, which compromise the ability of Nurses to provide quality care. Task shifting has been promoted as one strategy for making efficient use of human resources and addressing these issues. Aims and objectives We aimed to understand the nature and practice of Neonatal nursing in public hospitals in Nairobi so as to determine what prospect there might be for relieving pressure by shifting Nurses’ work to others. Methods This paper is based on an 18-month qualitative study of three newborn units of three public hospitals—all located in Nairobi county—using an ethnographic approach. We draw upon a mix of 32 interviews, over 250 h’ observations, field notes and informal conversations. Data were collected from senior nursing experts in newborn nursing, Neonatal Nurse in-charges, Neonatal Nurses, nursing students and support staff. Results To cope with difficult work conditions characterized by resource challenges and competing priorities, Nurses have developed a ritualized schedule and a form of ‘subconscious triage’. Informal, organic task shifting was already taking place whereby particular nursing tasks were delegated to students, mothers and support staff, often without any structured supervision. Despite this practice, Nurses were agnostic about formal institutionalization of task shifting due to concerns around professional boundaries and the practicality of integrating a new cadre into an already stressed health system. Conclusion Our findings revealed a routine template of Neonatal nursing work which Nurses used to control unpredictability. We found that this model of nursing encouraged delegation of less technical tasks to subordinates, parents and other staff through the process of ‘subconscious triage’. The rich insights we gained from this organic form of task shifting can inform more formal task-shifting projects as they seek to identify tasks most easily delegated, and how best to support and work with busy Nurses
Jacinta Nzinga - One of the best experts on this subject based on the ideXlab platform.
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collective strategies to cope with work related stress among Nurses in resource constrained settings an ethnography of Neonatal nursing in kenya
Social Science & Medicine, 2020Co-Authors: Jacob Mcknight, Mike English, Jacinta Nzinga, Joyline JepkosgeiAbstract:Abstract Kenyan Neonatal Nurses are asked to do the impossible: to bridge the gap between international standards of nursing and the circumstances they face each day. They work long hours with little supervision in ill-designed wards, staffed by far too few Nurses given the pressing need. Despite these conditions, a single Neonatal Nurse can be tasked with looking after forty sick babies for whom very close care is a necessity. Our 18-month ethnography explores this uniquely stressful environment in order to understand how Nurses operate under such pressures and what techniques they use to organise work and cope. Beginning in January 2015, we conducted 250 h of non-participant observation and 32 semi-structured interviews in three newborn units in Nairobi to describe how Nurses categorise babies, balance work across shifts, use routinised care, and demonstrate pragmatism and flexibility in their dealings with each other in order to reduce stress. In so doing, we present an empirically based model of the ways in which Nurses cope in a lower-middle income setting and develop early work in nursing studies that highlighted collective strategies for reducing anxiety. This allows us to address the gap left by prevalent theories of nursing stress that have focused on the personal characteristics of individual Nurses. Finally, we extend outwards from our ethnographic findings to consider how a deeper understanding of these collective strategies to reduce stress might inform policy, and why, even when the forces that create stress are alleviated, the underlying model of nursing work may prevail.
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Exploring the space for task shifting to support nursing on Neonatal wards in Kenyan public hospitals.
Human resources for health, 2019Co-Authors: Jacinta Nzinga, Jacob Mcknight, Joyline Jepkosgei, Mike EnglishAbstract:Nursing practice is a key driver of quality care and can influence newborn health outcomes where Nurses are the primary care givers to this highly dependent group. However, in sub-Saharan Africa, nursing work environments are characterized by heavy workloads, insufficient staffing and regular medical emergencies, which compromise the ability of Nurses to provide quality care. Task shifting has been promoted as one strategy for making efficient use of human resources and addressing these issues. We aimed to understand the nature and practice of Neonatal nursing in public hospitals in Nairobi so as to determine what prospect there might be for relieving pressure by shifting Nurses’ work to others. This paper is based on an 18-month qualitative study of three newborn units of three public hospitals—all located in Nairobi county—using an ethnographic approach. We draw upon a mix of 32 interviews, over 250 h’ observations, field notes and informal conversations. Data were collected from senior nursing experts in newborn nursing, Neonatal Nurse in-charges, Neonatal Nurses, nursing students and support staff. To cope with difficult work conditions characterized by resource challenges and competing priorities, Nurses have developed a ritualized schedule and a form of ‘subconscious triage’. Informal, organic task shifting was already taking place whereby particular nursing tasks were delegated to students, mothers and support staff, often without any structured supervision. Despite this practice, Nurses were agnostic about formal institutionalization of task shifting due to concerns around professional boundaries and the practicality of integrating a new cadre into an already stressed health system. Our findings revealed a routine template of Neonatal nursing work which Nurses used to control unpredictability. We found that this model of nursing encouraged delegation of less technical tasks to subordinates, parents and other staff through the process of ‘subconscious triage’. The rich insights we gained from this organic form of task shifting can inform more formal task-shifting projects as they seek to identify tasks most easily delegated, and how best to support and work with busy Nurses.
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Exploring the space for task shifting to support nursing on Neonatal wards in Kenyan public hospitals
BMC, 2019Co-Authors: Jacinta Nzinga, Jacob Mcknight, Joyline Jepkosgei, Mike EnglishAbstract:Abstract Background Nursing practice is a key driver of quality care and can influence newborn health outcomes where Nurses are the primary care givers to this highly dependent group. However, in sub-Saharan Africa, nursing work environments are characterized by heavy workloads, insufficient staffing and regular medical emergencies, which compromise the ability of Nurses to provide quality care. Task shifting has been promoted as one strategy for making efficient use of human resources and addressing these issues. Aims and objectives We aimed to understand the nature and practice of Neonatal nursing in public hospitals in Nairobi so as to determine what prospect there might be for relieving pressure by shifting Nurses’ work to others. Methods This paper is based on an 18-month qualitative study of three newborn units of three public hospitals—all located in Nairobi county—using an ethnographic approach. We draw upon a mix of 32 interviews, over 250 h’ observations, field notes and informal conversations. Data were collected from senior nursing experts in newborn nursing, Neonatal Nurse in-charges, Neonatal Nurses, nursing students and support staff. Results To cope with difficult work conditions characterized by resource challenges and competing priorities, Nurses have developed a ritualized schedule and a form of ‘subconscious triage’. Informal, organic task shifting was already taking place whereby particular nursing tasks were delegated to students, mothers and support staff, often without any structured supervision. Despite this practice, Nurses were agnostic about formal institutionalization of task shifting due to concerns around professional boundaries and the practicality of integrating a new cadre into an already stressed health system. Conclusion Our findings revealed a routine template of Neonatal nursing work which Nurses used to control unpredictability. We found that this model of nursing encouraged delegation of less technical tasks to subordinates, parents and other staff through the process of ‘subconscious triage’. The rich insights we gained from this organic form of task shifting can inform more formal task-shifting projects as they seek to identify tasks most easily delegated, and how best to support and work with busy Nurses
Roslyn Mayers - One of the best experts on this subject based on the ideXlab platform.
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a Neonatal Nurse training program in kangaroo mother care kmc decreases barriers to kmc utilization in the nicu
American Journal of Perinatology, 2014Co-Authors: Karen D Hendricksmunoz, Roslyn MayersAbstract:Objective This study assessed the impact of a Nurse simulation training program on perception of kangaroo mother care (KMC) value and transfer skill competency. Study Design An 8-item Likert scale skill survey tool and a 24-item Likert developmental care survey tool were used in a prospective cohort study to analyze perceptions of 30 Neonatal Nurses who underwent a comprehensive KMC simulation-based training program. Competency skills were evaluated pretraining and tracked by direct observation for 6 months posttraining. Pre- and postsurvey data were analyzed and KMC utilization for preterm infants born at ≤ 34 weeks' gestation was determined. Results Nurses' competency in infant transfer improved, especially in infants receiving nasal continuous positive airway pressure or ventilator support, from 30 to 93% or 10 to 50%, respectively, p Conclusions A comprehensive simulation-based KMC education program improved Nurses' perception of KMC value, their competency and comfort in infant transfer for KMC care, and successfully promoted KMC parent utilization for the preterm infant in the Neonatal intensive care unit.
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maternal and Neonatal Nurse perceived value of kangaroo mother care and maternal care partnership in the Neonatal intensive care unit
American Journal of Perinatology, 2013Co-Authors: Karen D Hendricksmunoz, Yang S Kim, Carol C Prendergast, Roslyn Mayers, Moi LouieAbstract:Background Kangaroo Mother Care (KMC) enhances infant and maternal well-being and requires maternal-care partnerships (MCP) for implementation. Objective To examine maternal and Neonatal Nurse provider perspectives on the value of KMC and MCP. Study Design Prospective cohort design of Neonatal Nurses and mothers of preterm infants self-report anonymous questionnaire. Analyses of categorical independent variables and continuous variables were calculated. Results In all, 82.3% of Nurses (42) and 100% (143) of mothers participated in the survey. compared with 18% of Nurses, 63% of mothers believed “KMC should be provided daily” and 90% of mothers compared with 40% of Nurses strongly believed “mothers should be partners in care.” In addition, 61% of nonwhite mothers identified that “KMC was not something they were told they could do for their infant” compared with 39% of white mothers. Nonwhite and foreign-born Nurses were 2.8 and 3.1 times more likely to encourage MCP and KMC. Conclusion Mothers held strong positive perceptions of KMC and MCP value compared with Nurses. Nonwhite mothers perceived they received less education and access to KMC. Barriers to KMC and MCP exist among Nurses, though less in nonwhite, foreign-born, and/or Nurses with their own children, identifying important provider educational opportunities to improve maternal KMC access in the NICU.
Karen D Hendricksmunoz - One of the best experts on this subject based on the ideXlab platform.
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a Neonatal Nurse training program in kangaroo mother care kmc decreases barriers to kmc utilization in the nicu
American Journal of Perinatology, 2014Co-Authors: Karen D Hendricksmunoz, Roslyn MayersAbstract:Objective This study assessed the impact of a Nurse simulation training program on perception of kangaroo mother care (KMC) value and transfer skill competency. Study Design An 8-item Likert scale skill survey tool and a 24-item Likert developmental care survey tool were used in a prospective cohort study to analyze perceptions of 30 Neonatal Nurses who underwent a comprehensive KMC simulation-based training program. Competency skills were evaluated pretraining and tracked by direct observation for 6 months posttraining. Pre- and postsurvey data were analyzed and KMC utilization for preterm infants born at ≤ 34 weeks' gestation was determined. Results Nurses' competency in infant transfer improved, especially in infants receiving nasal continuous positive airway pressure or ventilator support, from 30 to 93% or 10 to 50%, respectively, p Conclusions A comprehensive simulation-based KMC education program improved Nurses' perception of KMC value, their competency and comfort in infant transfer for KMC care, and successfully promoted KMC parent utilization for the preterm infant in the Neonatal intensive care unit.
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maternal and Neonatal Nurse perceived value of kangaroo mother care and maternal care partnership in the Neonatal intensive care unit
American Journal of Perinatology, 2013Co-Authors: Karen D Hendricksmunoz, Yang S Kim, Carol C Prendergast, Roslyn Mayers, Moi LouieAbstract:Background Kangaroo Mother Care (KMC) enhances infant and maternal well-being and requires maternal-care partnerships (MCP) for implementation. Objective To examine maternal and Neonatal Nurse provider perspectives on the value of KMC and MCP. Study Design Prospective cohort design of Neonatal Nurses and mothers of preterm infants self-report anonymous questionnaire. Analyses of categorical independent variables and continuous variables were calculated. Results In all, 82.3% of Nurses (42) and 100% (143) of mothers participated in the survey. compared with 18% of Nurses, 63% of mothers believed “KMC should be provided daily” and 90% of mothers compared with 40% of Nurses strongly believed “mothers should be partners in care.” In addition, 61% of nonwhite mothers identified that “KMC was not something they were told they could do for their infant” compared with 39% of white mothers. Nonwhite and foreign-born Nurses were 2.8 and 3.1 times more likely to encourage MCP and KMC. Conclusion Mothers held strong positive perceptions of KMC and MCP value compared with Nurses. Nonwhite mothers perceived they received less education and access to KMC. Barriers to KMC and MCP exist among Nurses, though less in nonwhite, foreign-born, and/or Nurses with their own children, identifying important provider educational opportunities to improve maternal KMC access in the NICU.
Jacob Mcknight - One of the best experts on this subject based on the ideXlab platform.
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collective strategies to cope with work related stress among Nurses in resource constrained settings an ethnography of Neonatal nursing in kenya
Social Science & Medicine, 2020Co-Authors: Jacob Mcknight, Mike English, Jacinta Nzinga, Joyline JepkosgeiAbstract:Abstract Kenyan Neonatal Nurses are asked to do the impossible: to bridge the gap between international standards of nursing and the circumstances they face each day. They work long hours with little supervision in ill-designed wards, staffed by far too few Nurses given the pressing need. Despite these conditions, a single Neonatal Nurse can be tasked with looking after forty sick babies for whom very close care is a necessity. Our 18-month ethnography explores this uniquely stressful environment in order to understand how Nurses operate under such pressures and what techniques they use to organise work and cope. Beginning in January 2015, we conducted 250 h of non-participant observation and 32 semi-structured interviews in three newborn units in Nairobi to describe how Nurses categorise babies, balance work across shifts, use routinised care, and demonstrate pragmatism and flexibility in their dealings with each other in order to reduce stress. In so doing, we present an empirically based model of the ways in which Nurses cope in a lower-middle income setting and develop early work in nursing studies that highlighted collective strategies for reducing anxiety. This allows us to address the gap left by prevalent theories of nursing stress that have focused on the personal characteristics of individual Nurses. Finally, we extend outwards from our ethnographic findings to consider how a deeper understanding of these collective strategies to reduce stress might inform policy, and why, even when the forces that create stress are alleviated, the underlying model of nursing work may prevail.
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Exploring the space for task shifting to support nursing on Neonatal wards in Kenyan public hospitals.
Human resources for health, 2019Co-Authors: Jacinta Nzinga, Jacob Mcknight, Joyline Jepkosgei, Mike EnglishAbstract:Nursing practice is a key driver of quality care and can influence newborn health outcomes where Nurses are the primary care givers to this highly dependent group. However, in sub-Saharan Africa, nursing work environments are characterized by heavy workloads, insufficient staffing and regular medical emergencies, which compromise the ability of Nurses to provide quality care. Task shifting has been promoted as one strategy for making efficient use of human resources and addressing these issues. We aimed to understand the nature and practice of Neonatal nursing in public hospitals in Nairobi so as to determine what prospect there might be for relieving pressure by shifting Nurses’ work to others. This paper is based on an 18-month qualitative study of three newborn units of three public hospitals—all located in Nairobi county—using an ethnographic approach. We draw upon a mix of 32 interviews, over 250 h’ observations, field notes and informal conversations. Data were collected from senior nursing experts in newborn nursing, Neonatal Nurse in-charges, Neonatal Nurses, nursing students and support staff. To cope with difficult work conditions characterized by resource challenges and competing priorities, Nurses have developed a ritualized schedule and a form of ‘subconscious triage’. Informal, organic task shifting was already taking place whereby particular nursing tasks were delegated to students, mothers and support staff, often without any structured supervision. Despite this practice, Nurses were agnostic about formal institutionalization of task shifting due to concerns around professional boundaries and the practicality of integrating a new cadre into an already stressed health system. Our findings revealed a routine template of Neonatal nursing work which Nurses used to control unpredictability. We found that this model of nursing encouraged delegation of less technical tasks to subordinates, parents and other staff through the process of ‘subconscious triage’. The rich insights we gained from this organic form of task shifting can inform more formal task-shifting projects as they seek to identify tasks most easily delegated, and how best to support and work with busy Nurses.
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Exploring the space for task shifting to support nursing on Neonatal wards in Kenyan public hospitals
BMC, 2019Co-Authors: Jacinta Nzinga, Jacob Mcknight, Joyline Jepkosgei, Mike EnglishAbstract:Abstract Background Nursing practice is a key driver of quality care and can influence newborn health outcomes where Nurses are the primary care givers to this highly dependent group. However, in sub-Saharan Africa, nursing work environments are characterized by heavy workloads, insufficient staffing and regular medical emergencies, which compromise the ability of Nurses to provide quality care. Task shifting has been promoted as one strategy for making efficient use of human resources and addressing these issues. Aims and objectives We aimed to understand the nature and practice of Neonatal nursing in public hospitals in Nairobi so as to determine what prospect there might be for relieving pressure by shifting Nurses’ work to others. Methods This paper is based on an 18-month qualitative study of three newborn units of three public hospitals—all located in Nairobi county—using an ethnographic approach. We draw upon a mix of 32 interviews, over 250 h’ observations, field notes and informal conversations. Data were collected from senior nursing experts in newborn nursing, Neonatal Nurse in-charges, Neonatal Nurses, nursing students and support staff. Results To cope with difficult work conditions characterized by resource challenges and competing priorities, Nurses have developed a ritualized schedule and a form of ‘subconscious triage’. Informal, organic task shifting was already taking place whereby particular nursing tasks were delegated to students, mothers and support staff, often without any structured supervision. Despite this practice, Nurses were agnostic about formal institutionalization of task shifting due to concerns around professional boundaries and the practicality of integrating a new cadre into an already stressed health system. Conclusion Our findings revealed a routine template of Neonatal nursing work which Nurses used to control unpredictability. We found that this model of nursing encouraged delegation of less technical tasks to subordinates, parents and other staff through the process of ‘subconscious triage’. The rich insights we gained from this organic form of task shifting can inform more formal task-shifting projects as they seek to identify tasks most easily delegated, and how best to support and work with busy Nurses
